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Biomedical subjects

A Brekkan

Publications and source records attributed to A Brekkan.

At least 19 recordsLinked to original sources
PubMed2000

Smoking, rheumatoid factor isotypes and severity of rheumatoid arthritis.

OBJECTIVES: Smokers have an increased incidence of rheumatoid factor (RF) and rheumatoid arthritis (RA) and one report has also indicated that smoking may also adversely influence the severity of RA. METHODS: Sixty-three women with advanced RA answered a structured questionnaire that included detailed information about their smoking history. The women were also evaluated clinically and radiologically. RESULTS: Heavy smoking (>/= 20 pack-yr) was associated with rheumatoid nodules (P: = 0.01), a higher HAQ score (P: = 0.002) and a lower grip strength (P: = 0.01). Smoking was also associated with more radiological joint damage (P: = 0.02). A positive correlation was observed between smoking and RF levels, in particular IgA RF and a combined elevation of IgM and IgA RF. CONCLUSIONS: Smoking has an adverse effect on disease progression in patients with RA. An association was also observed between smoking and those RF types that predispose to RA and have the highest diagnostic specificity for this disease.

Adult↗
PubMed1996

Hypermobility associated with osteoarthritis of the thumb base: a clinical and radiological subset of hand osteoarthritis.

OBJECTIVES: To study the impact of articular hypermobility on the clinical and radiological features of hand osteoarthritis (OA) and to investigate whether hand osteoarthritis associated with hypermobility should be considered a separate subset of hand OA. METHODS: Fifty consecutive female patients with clinical hand OA and thumb base symptoms were examined for hypermobility according to the Beighton criteria. RESULTS: Thirty one of the 50 patients had hypermobility features (Beighton score > or = 2) and 17 patients fulfilled four or more Beighton criteria. Corresponding figures for 94 control patients were 30 (p < 0.05) and nine (p < 0.001) respectively. Patients with hypermobility features were characterised clinically and radiologically by fewer and less severely involved interphalangeal joints. Radiologically, two fairly distinct subsets could be identified: Severe interphalangeal OA in which the prevalence of hypermobility was similar to controls, and patients with predominant involvement of the first carpometacarpal joint (CMC 1), most of whom had evidence of hypermobility. CONCLUSION: A causal relation exists between articular hypermobility and development of thumb base OA, and hypermobility associated hand OA constitutes a definite clinical and radiological subset of hand OA. In the clinical setting, the easily applied hypermobility criterion of passive dorsiflexion of the fifth finger > or = 90 degrees is useful in identifying most patients with hand OA and hypermobility.

Aged↗
PubMed1995

Angiographic predictors of new coronary occlusions.

To determine whether coronary angiography is predictive of the future site of coronary occlusion, we analyzed the coronary angiograms of 246 consecutive patients having two or more angiograms without therapeutic invasive intervention in the interval between angiograms. The average interval between studies was 46 months. Of 2183 normal segments at the first angiogram, 51 (2.3%) were occluded at the second angiogram, whereas in segments with minimal disease (1% to 25% diameter stenosis) 33 (8%) of 411 were occluded (p < 0.05). There was a further stepwise increase in the occlusion ratio, with increasing stenosis reaching a 31% occlusion ratio in lesions with critical (91% to 99%) stenosis at the first angiogram. For any given degree of stenosis, the occlusion ratio of "long" lesions (5 to 20 mm) was on the average more than twice that of "short" lesions (< 5 mm, p < 0.01), except in lesions with critical stenosis (91% to 99%) where length was no longer important. Occlusion of segments judged free of disease on the first angiogram was highest in the right coronary artery, 4.7%, versus 2.7% in the left anterior descending and 0.6% in the circumflex artery (p < 0.01). History of recent myocardial infarction was a good clinical predictor of occlusion and deterioration of ventricular function.

Coronary Angiography↗
PubMed1995

Use of X-rays in family practice. A multicentre study.

Practicing physicians, faced with pressure to control health care costs, are increasingly being asked to incorporate considerations of cost into their decisions regarding the care they offer their patients. Accordingly, it is of importance to know how the money is spent. The use and cost of X-rays in family practice, and what factors influence it, is not well known. The aim of this study is to analyse the use and the cost of X-ray requests in family practice. A prospective practice study from 16 Icelandic community health centres (HC) with computerised contact data and their target populations, 12 rural and four urban, was carried out. The X-ray requests, numbers, types and cost were analysed. Patient and practice characteristics were used to assess variation in X-ray practices. A total of 5173 X-ray requests were recorded, which comprised 3.2% of all office visits. The mean number of X-ray requests was 24.7 and 14.7/1000 contacts in rural and urban HCs respectively, and 123.1/1000 inhabitants in rural HCs. The X-ray request rate per individual increased with age, but per contact it was highest among young males. Extremity and chest X-rays were the most common requests. For every 1000 individuals added to a practice population, the likelihood of having an X-ray requested decreased by 18%. The use of X-ray examinations in family practices represents approximately 17% of all ambulatory X-ray use in Iceland. The calculated cost of X-rays requested in this study was $6157/1000 inhabitants per year as of October 1993.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Intraarticular ganglion between the cruciate ligaments of the knee. A case report.

Intraarticular ganglion cysts arising from the cruciate ligaments are rare. Only 9 cases have been described in the literature. Only in one case was the diagnosis suggested before operation by the appearance on MR imaging. We report a case of a patient presenting with a bone erosion in the proximal tibial epiphysis caused by an intraarticular ganglion cyst arising from the anterior cruciate ligament.

Anterior Cruciate Ligament↗
PubMed1989

Methotrexate treatment of rheumatoid arthritis: effects on radiological progression.

Radiological progression was evaluated in 15 patients with rheumatoid arthritis (RA) treated with methotrexate (MTX). Prior to MTX treatment, all the patients had failed on other slow-acting agents and all showed radiological deterioration. For each patient, three sets of radiographs of hands and wrists were evaluated: prior to MTX treatment while on other slow-acting agents, at the beginning of MTX treatment, and at the most recent evaluation on MTX. Two experienced radiologists evaluated the radiographs independently. The rate of radiological progression was calculated by dividing the change in radiological score by the number of months between sets of radiographs. The mean time from film set one to two (period one) was 29.4 months and from set two to three (period two) 32.5 months. The mean rate of radiological progression for period one was 0.576 and for period two, 0.381. Eight patients showed decline in radiological progression during MTX treatment.

Aged↗
PubMed1987

Relation between bone erosions and rheumatoid factor isotypes.

Total rheumatoid factor (RF) activity and individual RF isotypes were measured in 62 patients with rheumatic diseases. Retrospective analysis of available x rays showed an association between IgA RF and the occurrence of periarticular bone erosions in hands. In contrast, IgG RF and IgM RF did not show any significant association with erosions. Furthermore, a close correlation was observed between the RF isotype levels in simultaneously drawn serum and synovial fluid samples. The possible significance of IgA RF in the pathogenesis of bone erosions is discussed.

Adolescent↗
PubMed1986

Mass screening for breast cancer.

Breast cancer is now the most common cancer in women. There is a certain correlation between the stage of the disease at diagnosis and outcome after treatment. Several studies have been initiated involving mammography with or without physical examination aimed at early detection of breast cancer in asymptomatic women. In order to review the results to date, a meeting was held in Reykjavík in April 1984 organized by international and Icelandic health agencies and attended by senior investigators of the ongoing screening studies. A summary of the available data is presented in this paper along with the conclusions of the meeting.

Adult↗
PubMed1985

The penetration of metrizamide into the brain after routine lumbar myelography as shown by cerebral computed tomography and its effect on auditory brainstem transmission time.

Metrizamide is a widely used contrast medium with some well known adverse reactions. In a preliminary study, CT scans and brain stem evoked potentials (BAEP) were done before and 18 hours following lumbar myelography on 12 patients. A statistically significant prolongation of the BAEP was observed. Metrizamide therefore seems to be a potent substance in clinical use as indicated by its effect on BAEP. BAEP should not be done within the first few days after myelography with metrizamide.

Aged↗
PubMed1983

Radiographic examination of the lumbosacral spine: an 'age-stratified' study.

Of a total of 99 922 radiological requests, 3.3% were for examinations of the lumbosacral spine. An 'age-stratified' study of 657 females aged 15-44 years referred for lumbosacral examination was carried out. 17.3% were referred because of trauma, with a total fracture incidence of 4.1% as compared with 9.5% in the other age-sex groups. Analysis of the other reasons for referral and the radiological diagnoses showed that 80% of all referrals were for more or less non-specific reasons, summarised as lower-back pain; an equal percentage of the radiological diagnoses indicated that there was either no lesion or a lesion which did not influence management.

Adolescent↗
PubMed1975

Glass fragments and other particles contaminating contrast media.

Microscopy of filtrates made from contrast media of routinely opened glass ampoules substantiates previous assumptions that small fragments of glass may enter into the ampoule and the medium with considerable frequency. Such glass fragments may cause embolic lesions on intraarterial injections of the medium; the lesions, however, are histologically non-specific consisting of proliferation of intima and small granulomas associated with dilated nephrons in a ray-like arrangement. A significant amount of plastic particles may be added to injectable fluids on usage of disposable syringes.

Angiography↗